1. A model for multi-disciplinary care

1. A model for multi-disciplinary care

Hip fractures are the commonest reason for older adults to be admitted to hospital for emergency surgery — but the rest of their care isn’t about orthopaedics. Behind each fracture may lie frailty and a need for coordinated multidisciplinary teamwork. In this episode, we use hip fracture care as a lens to explore the wider challenges of caring for frail and older patients in hospital. From the early days of surgical defeatism to today’s orthogeriatric-led models and national audit, we ask: what can hip fracture care teach us about treatingolder adults more holistically?


Links:

‘Hip Fracture – the Cardiff approach’ on YouTube: https://www.youtube.com/playlist?list=PLH4P3rNfQEEswi7nEQQLTyyz7b2XVB4Ez

NICE Guideline: ⁠https://www.nice.org.uk/guidance/cg124⁠

National Hip Fracture Database (NHFD): ⁠https://www.nhfd.co.uk/⁠

BOA-BGS Blue Book:⁠ https://www.bgs.org.uk/sites/default/files/content/attachment/2018-05-02/Blue%20Book%20on%20fragility%20fracture%20care.pdf⁠

Hip fractures in the elderly: a world-wide projection: Cooper et al. Osteoporosis Int. 1992. https://pubmed.ncbi.nlm.nih.gov/1421796/

Geriatric Orthopaedics. Devas BMJ 1974. https://www.bmj.com/content/1/5900/190

Effectiveness of geriatric rehabilitation after proximal femur fracture in the elderly: Kennie et al. BMJ 1988. https://pmc.ncbi.nlm.nih.gov/articles/PMC1834847/

Prospective randomised study of an orthopaedic geriatric in-patient service: Gilchrist et al. BMJ 1988. ⁠ https://pubmed.ncbi.nlm.nih.gov/3143450/

Co-ordinated multidisciplinary approaches for inpatient rehabilitation of older patients with proximal femoral fractures: Cameron et al. Cochrane Database 2001 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000106/references

Questions and suggestions?

Email: Raihaan.Biju@wales.nhs.net



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Episoder(12)

11. "What anaesthetic do I need?" - with Iain Moppett

11. "What anaesthetic do I need?" - with Iain Moppett

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9. "Do I need an operation?"

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Hello everyone and welcome back to Season 2! We’re launching a three-part mini-series starting with an episode on the consent process — and how to respond when Grace asks, “Do I need an operation?” We...

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8. Breaking the pain cycle; analgesia in hip fracture care

8. Breaking the pain cycle; analgesia in hip fracture care

Hello everyone, and welcome back to our second season of The Rest Isn’t Orthopaedics! In this episode, we dive into the challenge of managing pain for Grace, our model hip fracture patient. We explore...

24 Sep 202521min

7. Preventing the next fracture

7. Preventing the next fracture

We’re almost ready to send Grace home! But if she does fall again, how can we prevent another fracture? In the final episode of our first season, we explore the key trials that have shaped our approac...

8 Sep 202516min

6. The tipping point; preventing falls

6. The tipping point; preventing falls

In today’s episode, we return to Grace’s story, which began with a fall. Preventing the next fall is just as important as treating the consequences of the first. We look at why older adults fall, the ...

8 Sep 202519min

5. Feeding recovery; the importance of nutrition

5. Feeding recovery; the importance of nutrition

Nutrition is often the missing piece in hip fracture recovery — yet it can mean the difference between regaining independence or facing decline. In this episode, we unpack the evidence behind nutritio...

8 Sep 202519min

4. Step by step; rethinking rehabilitation

4. Step by step; rethinking rehabilitation

Bed rest is no longer an option after hip fracture. Evidence shows that getting patients out of bed the day after surgery is one of the most powerful predictors of recovery. In this episode, we explor...

8 Sep 202515min

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